Environmental (Commonwealth Union)_ In Turkana County, Kenya, a silent crisis unfolds as erratic weather patterns and environmental degradation fuel the rise of neglected diseases like kala-azar, deepening the struggles of marginalised communities. This devastating disease, also known as visceral leishmaniasis, thrives in the arid landscapes of northern Kenya, where sandflies, its primary vector, find perfect breeding grounds in cracked soil and degraded land. The human cost of this crisis is stark, as families like that of 15-year-old herder Ekidor Kiyong grapple with its impact.
Ekidor, recovering at Lodwar County Referral Hospital, narrowly escaped the fatal consequences of kala-azar thanks to timely treatment. His aunt, Ester Loskiria, recounts how his symptoms mirrored malaria, leading to delayed recognition of the true cause. The burden of his treatment, which costs KES 30,000 (USD 230), weighs heavily on the family, a common challenge in Turkana, where poverty and inadequate healthcare infrastructure exacerbate the problem.
According to the World Health Organization (WHO), kala-azar is fatal in 95% of untreated cases, and its prevalence in Kenya is rising. The World Health Organization (WHO) reported 1,463 cases in 2019 alone, but estimates suggest the true figures may be far higher. In Turkana, outbreaks highlight the intersection of health inequities and environmental justice. Driven by the need for firewood and trade, deforestation has transformed the landscape, creating habitats where sandflies thrive. Meanwhile, climate change, with its rising temperatures and shifting rainfall patterns, intensifies the conditions conducive to disease spread.
For many, such as Charles Tukei from Nakutan village, the deadly toll of the disease is an unavoidable reality. After losing his five-year-old son to kala-azar, Tukei recalls the misdiagnosis that delayed critical treatment. In Turkana’s remote villages, awareness of the disease remains low, and over-the-counter remedies for presumed malaria often lead to catastrophic outcomes. Experts agree that improving early diagnosis and healthcare access is vital, but addressing the root causes requires a broader, multifaceted approach.
Environmental degradation is central to the crisis. In Loima, a sub-county of Turkana, deforestation and sand accumulation provide ideal conditions for sandflies. The situation exemplifies the dual threat posed by climate change and unsustainable land use practices. As Kennedy Wasilwa, a clinical officer at Lodwar hospital, explains, the region’s healthcare system struggles to meet the demand, particularly as advanced cases present severe complications like enlarged spleens and organ failure.
Across Kenya, efforts to combat kala-azar are gaining momentum. The WHO is introducing a shorter, two-week treatment protocol, combining intramuscular injections with oral medications to reduce hospital stays. Additionally, organisations like the Drugs for Neglected Diseases initiative (DNDi) are working with Kenya’s Ministry of Health to create sustainable interventions.
Cherinet Adera of DNDi underscores the link between environmental changes and disease transmission. He notes that sandflies thrive in the cracks of dry earth and humid lowland conditions exacerbated by deforestation and urbanisation. By displacing natural habitats, human activity brings communities closer to vectors, increasing the risk of outbreaks.
The fight against kala-azar requires an integrated approach. Public health experts like Samuel Kariuki from DNDi advocate for robust climate data to predict disease spread, combined with sustainable environmental practices to mitigate sandfly proliferation. Community engagement is equally crucial. Drawing lessons from Bangladesh, where coordinated efforts have reduced the disease burden, experts stress the importance of involving local populations in designing and implementing interventions.
Regional collaboration also plays a key role. Kenya, along with countries like Ethiopia, Sudan, and Uganda, has committed to eliminating kala-azar in East Africa. Their goal is ambitious: reduce the fatality rate to under 1% and cut prevalence by 90% within the next decade. Achieving this will require not only improved healthcare infrastructure but also a shift toward environmentally sustainable practices that address the root causes of disease transmission.
Despite the significant risks, there is a clear path forward. By empowering communities, investing in education and healthcare, and fostering collaboration among environmental scientists, public health experts, and policymakers, Turkana can become a symbol of resilience and recovery. The fight against kala-azar is more than a battle against a disease; it is a struggle for health equity, environmental justice, and the dignity of those most affected by climate change.
